NPIMap

Organization Active NPI

Clinica Union, Inc

  • Family Medicine Physician
  • Smyrna, GA
National Provider Identifier
1235505835
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA UNION, INC
Practice address
696 Windy Hill Rd SE
Smyrna, GA 30080-1857
Phone
(404) 321-4692
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mario Rivera, M.D
Title
Ceo
Phone
(404) 321-4692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

696 Windy Hill Rd SE
Smyrna, GA 30080-1857

Mailing address

3369 Buford Hwy NE
Suite 810
Brookhaven, GA 30329-3722
Phone (404) 321-4692

National Provider Directory

National Provider Directory
Tax ID family
Clinica Union Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

696 Windy Hill Rd SE
Smyrna, GA 30080
Phone (404) 321-4692

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1235505835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3369 BUFORD HWY NE",
            "address_2": "SUITE 810",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303293722",
            "telephone_number": "404-321-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 WINDY HILL RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801857",
            "telephone_number": "404-321-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA UNION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-321-4692",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.